We observed that the number of RIAO increased as the number of complications increased, and significantly so when a child with obesity presented any of the following comorbidities: glucose > 85 mg/dL but < 100 mg/dL, insulin resistance (HOMA and C-peptide), dyslipidemia (hypertriglyceridemia, hypoalphalipoproteinemia), hyperuricemia, alanine amino transferase (ALT) elevation and/or diastolic hypertension, (p = 0.003). The gene discussed is GPT; the disease is obesity due to melanocortin 4 receptor deficiency.